Classifications

• • G—PHYSICS
  • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
  • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
  • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
  • G16H20/40—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• • G—PHYSICS
  • G06—COMPUTING; CALCULATING OR COUNTING
  • G06N—COMPUTING ARRANGEMENTS BASED ON SPECIFIC COMPUTATIONAL MODELS
  • G06N20/00—Machine learning
• • G—PHYSICS
  • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
  • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
  • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
  • G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C19/00—Dental auxiliary appliances
  • A61C19/04—Measuring instruments specially adapted for dentistry
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C2203/00—Means for making patients feel at ease during dental treatment, e.g. dental instruments in the form of toys
• • G—PHYSICS
  • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
  • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
  • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
  • G16H50/70—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for mining of medical data, e.g. analysing previous cases of other patients
• • G—PHYSICS
  • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
  • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
  • G16H70/00—ICT specially adapted for the handling or processing of medical references
  • G16H70/20—ICT specially adapted for the handling or processing of medical references relating to practices or guidelines

Definitions

• the present invention relates to the field of oral health care, particularly in the clinical context.
• Anticipated treatment discomfort or pain is a significant barrier to patient compliance with regular consultation and treatment with dental practitioners.
• Treatment pain can cause a patient to develop dental anxiety.
• Experience of pain at a previous dental visit has been shown to be correlated with dental anxiety.
• An estimated 3-16% of adults suffer from dental phobia.
• Patient studies indicate that patients believe that dental practitioners (DPs) should pay attention to any discomfort (e.g., pain, stress, or anxiety) during treatment and that DPs should take steps to ameliorate this.
• anticipated treatment discomfort is not a major cause of anxiety for the whole patient population.
• 60% reported having at least one dental experience involving ‘strong pain’, of which only 5-6% experienced dental treatment in general to be very painful.
• dental treatment steps can be applied in a way that minimizes patient pain, thereby reducing anxiety about future treatment.
• Dental practitioners typically seek to do this as part of their standard practice, by anticipating steps which are likely to cause more pain than others and giving clear warnings and reassurances to a patient, and taking extra care or working more slowly during these steps.
• particularly more experienced DPs are able to carry out a single treatment with multiple different treatment styles or philosophies, and are able to vary the treatment style according to the pain experienced by the patient in each step, e.g., speed up treatment steps that inflict less pain and take a careful approach when pain is expected.
• a DP it would be beneficial for a DP to be able to estimate the expected treatment discomfort for a particular step in the procedure also taking account of dentist’s treatment style (i.e., the approach or attitude of the DP towards conducting certain treatments).
• the DP could e.g., speed up treatment steps that inflict less pain, while taking a more careful approach when pain is expected. This way, dentists can adapt their treatment style to the needs of the patient.
• a computer-implemented method for use in providing guidance to a dental practitioner in respect of a dental treatment comprises running a prediction algorithm.
• the prediction algorithm is configured to receive input variables comprising at least: a type of treatment required by the patient, for example selected from a pre-defined set of possible treatment types.
• the prediction algorithm is further configured to generate an output prediction dataset comprising a predicted measure of treatment pain for each of a series of steps comprised by the input type of treatment.
• the method further comprises running a guidance algorithm, the guidance algorithm configured to: access the prediction dataset; generate guidance information indicative of the predicted treatment pain for at least a subset of the series of treatment steps; and control a user interface to generate at least one user-perceptible output indicative of the guidance information.
• the input variables which the prediction algorithm is configured to take as input may further include a treatment style to be implemented by the dental practitioner, for example selected from a pre-defined set of possible treatment styles.
• an algorithm to predict in advance pain associated with particular steps of a particular treatment, and optionally given the treatment style of the dental practitioner.
• This can preferably then be used to generate guidance for the dental practitioner. This could be generated in real time during treatment, or could be generated ahead of time, for instance in a report, which the dental practitioner can then use to plan their approach to different steps of the treatment to preemptively try to ameliorate or mitigate the pain in the different steps.
• the prediction algorithm comprises at least one trained machine learning algorithm.
• the machine learning algorithm could be trained using a training database that contains real-world measured data regarding pain associated with different steps of a treatment and optionally for different treatment styles. In this way, the algorithm can be trained to classify expected treatment pain levels or amounts for particular treatment steps and optionally a given treatment style.
• Embodiments provides an improved patient experience due to the better management of treatment pain. It provides an overall improved health outcome for the patient by predicting pain during the treatment and providing the DP guidance to manage the pain. This may improve compliance by the patient with treatment provider visits. Another advantage is improved staff experience by reducing occupational stress for the dentist. Another advantage is lower cost of care by reducing chair time.
• the treatment styles are treatment style classifications, i.e. a set of classifications indicative of a style of administration of treatment .
• the pre-defined set of possible treatment styles may be defined by a list or data record.
• the treatment styles may be custom defined, or may be defined by a specific clinical standard.
• the pre-defined set of possible treatment styles may include one or more of: slow, careful approach; more rapid, forceful approach; mechanical approach; pharmaceutical approach.
• Another example is a minimal anesthesia approach in which anesthesia use is minimized.
• Another approach is a precautionary antibiotics approach in which antibiotics are administered after any dental treatment, on a ‘just in case’ basis.
• Another approach is a minimal antibiotics approach in which antibiotics are administered only if essential.
• Another approach is a fast/flexible approach in which a practitioner, upon performing dental examination will give the option to perform the needed treatment straight away (even if this may be more painful that waiting for an appointment some weeks later for which preparations could be made for anesthesia).
• Another approach is a precautionary treatment approach in which superficial caries would be treated with mechanical (drilling) treatment.
• Another approach (opposite to the precautionary treatment approach) would be the minimal treatment approach in which a response to superficial caries would be to prescribe a high fluoride toothpaste, and/or to administer a fluoride rinse, and to schedule monitoring appointments.
• the method may comprise controlling the user interface to generate an ordered sequence of user perceptible outputs, each indicative of the predicted treatment pain for one of the series of treatment steps.
• the guidance can be generated in sequence or in step with the steps of the treatment, providing the dental practitioner with guidance ahead of each step in the treatment.
• the generation of each next user-perceptible output could be triggered by a user input from the user interface, or for example triggered according to a pre-defined timing schedule.
• the timing schedule could be pre-defined in advance of execution of the guidance algorithm based on a user input.
• the method comprises accessing a scheduling database storing records indicative of scheduled treatment sessions, each record including at least an indication of a type of treatment to be performed.
• the method may further comprise receiving information indicative of a treatment style to be implemented by the dental practitioner, and optionally wherein the treatment style to be implemented is also comprised as part of each data record in the scheduling database.
• the method may further comprise generating the input variables for the prediction algorithm based on said accessing and said receiving steps.
• the input variables to the prediction algorithm further include one or more patient oral health characteristics.
• the prediction algorithm includes a machine learning algorithm pre-trained using a training database comprising respective data entries for each of a plurality of prior visits by a plurality of different patients to a set of different dental treatment providers, and wherein each visit entry includes at least an indication of: a type of treatment administered; and a measure indicative of treatment pain for each of a series of steps comprised by the treatment.
• each visit entry of the training database further includes an indication of a treatment style, where the treatment style is one of the said pre-defined set of treatment styles.
• At least a subset of the visit entries may further include an indication of one or more of: a treatment duration; a treatment cost; one or more oral health characteristics of the patient; a geographical location of the treatment provider; and/or one or more patient personality or demographic characteristics.
• the geographical location could for example be useful for benchmarking a dental practitioner against practitioners in a similar geographical area in terms of the pain experience of different treatments.
• the predicted measure indicative of treatment pain for each of the series of steps of the treatment is a quantitative measure.
• the measure indicative of treatment pain for each of the series of steps corresponds to a total measured pain amount, the total measured pain amount corresponding to a product of a measured pain response level and a time for which the pain response level was experienced, for each of one or more pain response episodes of each treatment step.
• the measure indicative of treatment pain for each of the series of steps comprises a maximum or peak pain level experienced during the respective treatment step. In some embodiments, within each visit entry, the measure indicative of treatment pain for each of the series of steps comprises a measure of a maximum rate of change of pain level experienced during each of the treatment steps. A rapid increase in pain level (e.g. from a zero pain level or low pain level), even if the pain level reached is not high, may give a significant pain sensation.
• the method further comprises obtaining a measure indicative of estimated actual treatment pain for at least a subset of the steps of the treatment.
• the method further comprises comparing for each of the at least subset of steps the estimated actual treatment pain and the predicted treatment pain.
• the method further comprises generating feedback information for the dental practitioner based on the comparison, e.g. indicative of a result of the comparison.
• the method may comprise adjusting the predicted measures of treatment pain based on a detected disparity between predicted and actual treatment pain for at least a subset of previous steps in the treatment.
• the measure indicative of estimated actual treatment pain for each of said at least subset of steps of the treatment is received in real time during performance of each of the subset of the steps of the treatment by the dental practitioner, and wherein the comparison and feedback generation are performed in real time with receipt of the estimated actual treatment pain for each step.
• the obtaining a measure indicative of estimated actual treatment pain for at least a subset of the steps of the treatment comprises: receiving, during each of the at least subset of steps of the treatment, a biological signal for the subject from a biological signal sensing apparatus coupled to the subject; identifying physiological response events in the biological signal; determining the measure indicative of estimated actual treatment pain for each said step of the treatment based on the physiological response events identified for that step.
• the biological signal may be a physiological parameter signal.
• the biological signal may be one of: a heart rate signal, and a skin conductance sensor signal.
• the obtaining a measure indicative of estimated actual treatment pain for the at least subset of the steps of the treatment may further comprise: receiving an indication of timings of a series of oral contact events, each contact event corresponding to mechanical engagement of an oral tool with a surface within the oral cavity of a subject; and determining a temporal proximity between each physiological response event and an immediately preceding contact event, and classifying a subject pain and/or non-pain arousal associated with the physiological response event based thereon.
• the method further comprises: receiving data indicative of motion and/or force patterns of a dental tool during at least one step of the treatment; and applying a treatment style analyzer algorithm configmed to estimate based on the motion and/or force patterns a treatment style associated therewith.
• the treatment style analyzer algorithm could be a machine learning algorithm trained to generate a treatment style classification based on the input motion and/or force data.
• the method may further comprise re-running the prediction algorithm using the treatment style estimated by the treatment style analyzer algorithm to generate a new prediction of the measure of treatment pain for the at least one step. In some embodiments, the method may further comprise generating a user-perceptible output indicative of the new prediction.
• the estimated pain levels per step can for example be updated based on treatment style in real-time.
• Another aspect of the invention is a computer program product comprising code means configured, when run on a processor to cause the processor to perform a method in accordance with any embodiment set out in this document, or in accordance with any claim of this application.
• Another aspect of the invention is a processing unit, comprising: an input/output; and one or more processors.
• the one or more processors are adapted to run a prediction algorithm.
• the prediction algorithm optionally may comprise at least one trained machine learning algorithm.
• the prediction algorithm is configured to: receive input variables comprising at least: a type of treatment required by the patient, and optionally a treatment style to be implemented by the dental practitioner, each selected from a pre-defined set of possible treatment types and styles, and generate an output prediction dataset comprising a predicted measure of treatment pain for each of a series of steps comprised by the input type of treatment.
• the one or more processors may be further adapted to run a guidance algorithm.
• the guidance algorithm may be configured to: access the prediction dataset, generate guidance information indicative of the predicted treatment pain for at least a subset of the series of treatment steps, and control a user interface to generate at least one user-perceptible output indicative of the guidance information.
• Fig. 1 outlines steps of an example method in accordance with one or more embodiments of the invention
• FIG. 2 schematically outlines components and a processing flow of an example processing arrangement in accordance with one or more embodiments of the invention
• FIG. 3 schematically illustrates processing flow in accordance with one or more embodiments of the invention.
• FIG. 4 schematically illustrates processing flow in accordance with a further one or more embodiments of the invention.
• the invention provides a method and system for generating prediction information comprising a predicted measure of treatment pain associated with each of a series of steps to be performed as part of a dental treatment by a dental practitioner.
• a machine learning algorithm could be used, which is trained on historical pain measurement information for the same type of treatment. This allows the algorithm to learn from the historical pain associated with different steps. This information can be output as guidance for the practitioner, allowing them to adapt their treatment style or approach for each step to pre-emptively mitigate expected pain.
• Fig. 1 outlines in block diagram form steps of an example method according to one or more embodiments. The steps will be recited in summary, before being explained further in the form of example embodiments.
• the method 8 is a computer-implemented method for use in providing guidance to a dental practitioner in respect of a dental treatment.
• the method 8 comprises running a prediction algorithm 10.
• the prediction algorithm is configured to receive 12 input variables comprising at least: a type of treatment required by the patient, for example selected from a pre-defined set of possible treatment types.
• the prediction algorithm is further configured to generate 14 an output prediction dataset comprising a predicted measure of treatment pain for each of a series of steps comprised by the input type of treatment.
• the inputs received by the prediction algorithm may further include a treatment style to be implemented by the dental practitioner, for example selected from a pre-defined set of possible treatment styles.
• the method 8 may further comprise running a guidance algorithm, the guidance algorithm 20.
• the guidance algorithm may be configured to: access 22 the prediction dataset; generate 24 guidance information indicative of the predicted treatment pain for at least a subset of the series of treatment steps; and control 26 a user interface to generate at least one user-perceptible output indicative of the guidance information.
• the prediction algorithm comprises at least one trained machine learning algorithm.
• the method might for example comprise controlling 26 the user interface to generate an ordered sequence of user perceptible outputs, each indicative of the predicted treatment pain for one of the series of treatment steps.
• the generation of each next user-perceptible output could be triggered by a user input from the user interface, or is triggered according to a pre-defined timing schedule.
• the timing schedule could be pre-defined in advance of execution of the guidance algorithm based on a user input.
• the input variables to the prediction algorithm further include one or more patient oral health characteristics.
• the prediction algorithm may be pre-trained in this case to generate predicted pain tailored to the particular one or more health characteristics.
• One illustrative example for instance is whether the patient is prone to gingivitis, in which case, more pain might be predicted.
• Other examples of oral health characteristics may include, by way of illustration: presence or absence of sensitive gums, presence of an infection, recent intervention history (e.g. extraction, pocket treatment), presence of an abscess or damage to the root of a tooth, or jaw problems (e.g. TMJ - pain opening the jaw).
• the method may further comprise accessing a scheduling database storing records indicative of scheduled treatment sessions, each record including at least an indication of a type of treatment to be performed. This step results in obtaining information of the treatment type which is to be administered for a particular patient.
• the scheduling database might be queried using patient identification information, to obtain the scheduling record for a relevant patient, and from this obtain the indication of the treatment type.
• the method may further comprise receiving information indicative of a treatment style to be implemented by the dental practitioner.
• a treatment style to be implemented by the dental practitioner For example this might be input by the dental practitioner to a user input device, or the treatment style to be implemented could also be comprised as part of each data record in the scheduling database, and be obtained from this record.
• the method may comprise generating the input variables for the prediction algorithm based on said accessing and said receiving steps. Thus, this automates the process of obtaining the needed inputs to the prediction algorithm.
• the treatment styles could include one or more of: slow, careful approach; more rapid, forceful approach; mechanical approach; pharmaceutical approach.
• Another example is a minimal anesthesia approach in which anesthesia use is minimized.
• Another approach is a precautionary antibiotics approach in which antibiotics are administered after any dental treatment, on a ‘just in case’ basis.
• Another approach is a minimal antibiotics approach in which antibiotics are administered only if essential.
• Another approach is a fast/flexible approach in which a practitioner, upon performing dental examination will give the option to perform the needed treatment straight away (even if this may be more painful that waiting for an appointment some weeks later for which preparations could be made for anesthesia).
• Another approach is a precautionary treatment approach in which superficial caries would be treated with mechanical (drilling) treatment.
• Another approach (opposite to the precautionary treatment approach) would be the minimal treatment approach in which a response to superficial caries would be to prescribe a high fluoride toothpaste, and/or to administer a fluoride rinse, and to schedule monitoring appointments.
• the pre-defined set of treatment styles can be defined in whatever way is desired. Each would be given a label or name, and a definition of it (in terms of its characteristics) would be defined in advance. This would be known to the dental practitioner. Then, when providing treatment style information for input to the prediction algorithm, the dental practitioner could use the known definitions to decide what style of the list best matches his or her own style.
• the treatment providers who contribute data to this database would also be provided the list of pre-defined treatment styles with its definitions of each style, and in this way they could label or tag each treatment session data entry with the corresponding style that best matches the style that was used for that treatment.
• Fig. 2 presents a schematic representation of an example processing unit 32 configured to execute a method in accordance with one or more embodiments of the invention, and also schematically showing the processing flow in more detail.
• the processing unit 32 comprises one or more processors (not shown) and may comprise an input/output.
• the one or more processors are adapted to run a prediction algorithm 34, and the prediction algorithm configured to: receive input variables comprising at least: a type of treatment 38 required by the patient, for example selected from a pre-defined set of possible treatment types.
• the input variables may further include at least a treatment style 40 to be implemented by the dental practitioner.
• the prediction algorithm 34 is further configured to generate an output prediction dataset comprising a predicted measure of treatment pain 42 for each of a series of steps comprised by the input type of treatment.
• the prediction algorithm may comprise at least one trained machine learning algorithm.
• the one or more processors of the processing unit 32 may be further adapted to run a guidance algorithm 20, the guidance algorithm configured to access the prediction dataset, and generate guidance information 52 indicative of the predicted treatment pain for at least a subset of the series of treatment steps, and control a user interface 62 to generate at least one user- perceptible output 64 indicative of the guidance information.
• the user interface 62 may comprise a display device for generating visual user-perceptible outputs.
• This may for example be a display device connected with a computing device located for example in the treatment room used by the dental practitioner. In this way the dental practitioner can be provided the guidance information during the treatment.
• the user interface could be located elsewhere, for example enabling the dental practitioner to review the guidance in advance of the treatment.
• the processing unit 32 could be part of a computing device of the dental practitioner, for example a mobile computing device, for example a smartphone or tablet. It could be part of a dental device in other examples. It could be part of a cloud-based server in some examples. It could be part of a computing workstation in some examples.
• a processor which is configmed to execute an algorithm that is programmed to:
• a part of the method may include the use of a prediction algorithm in the form of a trained machine learning algorithm. Details in respect of the trained machine learning algorithm will now be discussed in further detail.
• a machine-learning algorithm is any self-training algorithm that processes input data in order to produce or predict output data.
• the input data comprises, at minimum, the treatment type required by the patient, and optionally also a treatment style to be implemented by the dental practitioner, and the output data comprises a predicted measure of treatment pain for each of a series of steps comprised by the input type of treatment.
• Suitable machine-learning algorithms for being employed in the present invention will be apparent to the skilled person.
• suitable machine-learning algorithms include decision tree algorithms and artificial neural networks.
• Other machine-learning algorithms such as logistic regression, support vector machines, Naive Bayesian models, and k-nearest neighbor models are suitable alternatives.
• Neural networks are comprised of layers, each layer comprising a plurality of neurons.
• Each neuron comprises a mathematical operation.
• each neuron may comprise a different weighted combination of a single type of transformation (e.g. the same type of transformation, sigmoid etc. but with different weightings).
• the mathematical operation of each neuron is performed on the input data to produce a numerical output, and the outputs of each layer in the neural network are fed into the next layer sequentially. The final layer provides the output.
• Methods of training a machine-learning algorithm are well known.
• such methods comprise obtaining a training dataset, comprising training input data entries and corresponding training output data entries.
• An initialized machine-learning algorithm is applied to each input data entry to generate predicted output data entries.
• An error between the predicted output data entries and corresponding training output data entries is used to modify the machine-learning algorithm. This process can be repeated until the error converges, and the predicted output data entries are sufficiently similar (e.g. ⁇ 1%) to the training output data entries. This is commonly known as a supervised learning technique.
• the machine-learning algorithm is formed from a neural network
• (weightings of) the mathematical operation of each neuron may be modified until the error converges.
• Known methods of modifying a neural network include gradient descent, backpropagation algorithms and so on.
• the training dataset may be based on data contained in a database which comprises respective data entries for each of a plurality of prior/historical treatment sessions by a plurality of different patients to a set of different dental treatment providers, and wherein each treatment session entry includes at least an indication of:
• treatment style is one of the said pre-defined set of treatment styles.
• the training input data entries of the training data may correspond to the type of treatment needed by the patient and optionally the treatment style.
• the training output data entries may correspond to a measure indicative of predicted pain for each of a series of steps of the treatment type.
• a prediction algorithm which comprises a plurality of trained machine learning algorithms, wherein each has been trained using a filtered subset of the training dataset comprising only those training data entries which correspond to a particular respective one of the treatment styles.
• the training input data for each of the machine learning algorithms may comprise just the type of treatment (at minimum) and the training output data entries may comprise (at minimum) just the predicted measure of treatment pain.
• the algorithm may use the input variable indicative of the treatment style to be implemented by the dental practitioner to select the particular one of the plurality of trained machine learning algorithms which has been trained to generate pain predictions for the particular input treatment style.
• This machine learning algorithm may then be run by the prediction algorithm with an input comprising the type of treatment needed by the patient, and wherein the algorithm generates an output indicative of a predicted measure of pain for each of a series of steps of the treatment for the particular treatment style which indicated by the input variable.
• At least a subset of the treatment session data entries in the training database may further include an indication of one or more of: a treatment duration; a treatment cost; one or more oral health characteristics of the patient; a geographical location of the treatment provider; and/or one or more patient personality characteristics; and wherein the machine learning algorithm is trained accordingly.
• the measure indicative of treatment pain for each of the series of steps included in the data entries is a quantitative measure.
• it may correspond to a measured total pain amount.
• the total measured pain amount may correspond to a product of a measured pain response level and a time for which the pain response level was experienced, for each of one or more pain response episodes.
• the measure indicative of treatment pain for each of the series of steps may correspond to a maximum or peak pain level experienced during the respective treatment step.
• the measure indicative of treatment pain for each of the series of steps may correspond to a rate of change in the pain level experienced during the respective treatment step, or a maximum rate of change in the pain level experienced during the treatment step.
• the pain information can be derived from a biological sensing signal acquired as a function of time during the treatment in the plurality of historical treatment sessions.
• an objective measure of treatment pain can be derived in the following way, for generating the data entry for the database.
• a processor at the treatment provider office can be adapted for classifying a subject’s response to a series of contact events during a measurement session, the processor adapted to: receive, during the measurement session, an indication of timings of a series of oral contact events, each contact event corresponding to mechanical engagement of an oral tool with a surface within the oral cavity of a subject; receive, during the measurement session, a biological signal for the subject from a biological signal sensing apparatus coupled to the subject; identify physiological response events in the biological signal; determine a temporal proximity between each physiological response event and an immediately preceding contact event, and classify a subject pain and/or non-pain arousal associated with the physiological response event based thereon.
• a physiological response event may take the form of a fluctuation or oscillation in the signal, e.g. a peak or drop in the signal.
• the processor may be configured to classify a physiological response event as associated with a pain state dependent on the physiological response event occurring within a pre-defined time window immediately following a contact event.
• the classification can further comprise determining a pain level of the pain state based on one or more properties of the physiological response event peak or drop, and preferably wherein the one or more properties include a maximum height of a leading edge of the peak or drop.
• the classification can be performed in real time during the measurement session, and for each individual epoch corresponding to each respective step of the treatment.
• the processor can be adapted to compute a total pain amount over the time periods spanned by each respective treatment step, the total pain amount being a product of a pain level and a time for which the pain was experienced, the pain level being computed for each physiological response event peak or drop having a pain classification based on one or more properties of the physiological response event peak or drop.
• the processor can also be configured to classify a physiological response event as associated with a non-pain arousal state dependent on the physiological response event occurring outside of a time window of pre-defined duration following any contact event.
• the processor could optionally be adapted to further compute a total non-pain arousal amount over the time period spanned by each treatment step, the total non-pain arousal amount being a product of an arousal level and a time for which the arousal was experienced, the arousal level being computed for each physiological response event peak or drop having a non-pain arousal classification based on one or more properties of the physiological response event peak or drop.
• a system comprising: a contact identification means for identifying timings of a series of oral contact events, each contact event corresponding to mechanical engagement of an oral tool with a surface within the oral cavity of a subject; a biological signal sensing apparatus for measuring a physiological response of the subject (such as a skin conductance sensor or heart rate sensor or any other biosignal sensor); and a processor as already described, arranged to receive, over a measurement session, one or more contact signals from the contact identification means indicative of timings of the series of oral contact events and a biological signal from the biological signal sensing apparatus.
• the measure of treatment pain recorded in the database used to train the machine learning algorithm could, for each database treatment session entry, correspond to the total pain amount measured over each individual treatment step, or could correspond to the highest experienced pain level during each treatment step, or could correspond to an average pain level throughout the time period covered by each treatment step, or a ratio of total pain to total non pain amount during each treatment step, or any other variable or parameter derived from the biosignal pain data discussed above acquired during each historical treatment session and for each treatment step.
• This information could then be stored as an entry in the database which is used to train the prediction algorithm 34, along with indication of the type of treatment administered, and optionally a treatment style, where the treatment style is one of the said pre-defined set of treatment styles.
• another aspect of this invention may be the compilation of the training dataset referred to above, using the pain measurement technique mentioned above, or another objective pain measurement technique.
• Another aspect of the invention may be the training of the prediction algorithm in accordance with the example method already described above.
• An aspect of the invention could include a combination of the compilation of the training database using the pain measurement technique described above and the training of the prediction algorithm using this training database in accordance with the example method described above.
• An embodiment of the invention may comprise: the compilation of the training database using for example one or more features of the pain measurement technique described above, or another technique; the training of the machine learning algorithm comprised by the prediction algorithm using this training database; and the execution of the pain prediction method steps and optionally guidance generation method steps already recited above with reference to Fig. 1 (or any other embodiment / example of this method outlined in this document, or in accordance with any claim of this application).
• a system and method is provided which is configured for providing feedback or training information for a dental practitioner during a treatment part of a patient consultation.
• an algorithm is trained using a large patient database resulting, for example, from objective pain measurements recorded using the methods already discussed, based on measured biological signals during historical treatment sessions.
• This training database might for example include for each case at least information on: a type of treatment (e.g. cleaning), a style or philosophy of treatment (e.g. mechanical, careful approach, forceful approach), a measure of the experienced treatment pain, preferably during each step of the treatment (e.g. visual analogue scales, or skin responses), and optionally: treatment time, treatment costs, and/or patient oral health characteristics (e.g. prone to gingivitis).
• a type of treatment e.g. cleaning
• a style or philosophy of treatment e.g. mechanical, careful approach, forceful approach
• a measure of the experienced treatment pain preferably during each step of the treatment
• treatment e.g. visual analogue scales, or skin responses
• treatment time, treatment costs, and/or patient oral health characteristics e.g. prone to gingivitis
• the algorithm receives information on the type of treatment 38 (e.g. from a dental records or scheduling system or database of the dental practitioner).
• the algorithm also receives an indication of a treatment style or philosophy of the dental practitioner (e.g. self-reported upfront or measured in realtime).
• the algorithm may also receive information indicative of one or more patient oral health characteristics 72.
• a pain prediction algorithm 34 embodied in a processor 32, is configured to predict the expected treatment pain 42 of each step in the procedure, preferably taking into account the treatment style of the dental practitioner.
• These estimated pain levels per treatment step are then presented visually 64 to the dental practitioner, for guidance or for personalized training purposes (e.g. by showing a pain prediction score per step).
• the dental practitioner could for example choose to adapt his or her treatment by, e.g. speeding up parts that are not predicted to cause a lot of discomfort and being careful during parts that are likely to cause discomfort.
• the processor 32 is further configured to compare 76 the expected treatment pain, preferably considering the treatment style of the dental practitioner, with the average treatment pain for similar treatment types, across all styles, and feeds this information back to the dental practitioner.
• the processor may generate and output recommendations 84 to adapt the treatment style to mitigate pain, such as: suggesting an alternative treatment style, scheduling an appointment for the treatment with more or less time, adding or adapting a dose of anesthesia, suggesting a greater number or fewer support staff, and/or providing specific warnings or instructions to the patient up-front.
• the output predicted treatment pain may be used to benchmark 82 the treatment style and skill of different staff members within one dental practice or between dental practices - thereby improving the quality of care.
• a means may be provided to measure the actual treatment pain (e.g. visual analogue scales, or through measurement of a biological signal such as electrodermal activity).
• the patient’s pain levels 94 are assessed at each (or at least a subset) of the steps of the treatment. Then, either after or during the treatment or consultation, the processor 32 is configured to compare 78 the actual pain levels 94 to the estimated pain levels 42. This comparison may be fed back as output information to the dental practitioner. They may be output through visual presentation 64 by user an user interface for example. This information may function for example as personalized training for the dental practitioner.
• the comparisons 78 between estimated 42 and actual treatment pain 94 per step can be used for benchmarking purposes 82.
• the actual 94 treatment pain, together with the other characteristics of the treatment can be used to update the training database 92 which is used to train the prediction algorithm 34.
• the prediction algorithm may be recurrently re-trained using the recurrently updated training database 92.
• the method of any embodiment might comprise steps of: obtaining a measure indicative of estimated actual treatment pain for at least a subset of the steps of the treatment; comparing for each of the at least subset of steps the estimated actual treatment pain and the predicted treatment pain; and generating feedback information for the dental practitioner based on the comparison, e.g. indicative of a result of the comparison.
• the measure indicative of estimated actual treatment pain for each of said at least subset of steps of the treatment can be received in real time during performance of each of the subset of the steps of the treatment by the dental practitioner.
• the comparison and feedback generation are performed in real time with receipt of the estimated actual treatment pain for each step. This allows the dentist to adapt their approach for each step in real time.
• the measure indicative of estimated actual treatment pain for at least a subset of the steps of the treatment may comprise: receiving, during each of the at least subset of steps of the treatment, a biological signal for the subject from a biological signal sensing apparatus coupled to the subject; identifying physiological response events in the biological signal; and determining the measure indicative of estimated actual treatment pain for each said step of the treatment based on the physiological response events identified for that step.
• means may optionally be provided for measuring the treatment style of the dental practitioner in real-time (e.g. through pressure and movement sensors integrated in the treatment tools).
• the predictions as to pain levels per step can optionally be updated based on changes in the treatment style in real-time.
• the method may further comprise in some embodiments: receiving data indicative of motion and/or force patterns of a dental tool during at least one step of the treatment; and applying a treatment style analyzer algorithm configmed to estimate based on the motion and/or force patterns a treatment style associated therewith. This process may be performed for each step of the treatment.
• the treatment style analyzer algorithm could be a machine learning algorithm trained to associate particular patterns of force and/or motion with particular treatment styles, or it could be a rulebased algorithm which applies pre-define criteria, such as threshold ranges for different force/motion parameters, to classify the treatment style.
• the method may further comprise re-running the prediction algorithm using the treatment style estimated by the treatment style analyzer algorithm to generate a new prediction of the measure of treatment pain for the at least one step; and generating a user-perceptible output indicative of the new prediction.
• the pain prediction algorithm may be adapted to have communicative access to the database 92 which is used to train the prediction algorithm.
• the method may further comprise relating information about an upcoming scheduled treatment session to similar cases in the training database, e.g. based on treatment type, treatment style, and/or patient oral health characteristics. This may be done by querying the database to find such similar previous cases. For example a nearest neighbor approach might be employed. Based on the similar particular cases identified from the database, an expected treatment pain for different steps of the upcoming treatment might be predicted based on the measures of pain recorded in the identified previous cases.
• the invention can be embodied in software form.
• a computer program product comprising code means configured, when run on a processor, to cause the processor to perform a method in accordance with example or embodiment of the invention described in this document, or in accordance with any claim of this patent application.
• Embodiments of the invention described above employ a processing unit.
• the processing unit may in general comprise a single processor or a plurality of processors. It may be located in a single containing device, structure or unit, or it may be distributed between a plurality of different devices, structures or units. Reference therefore to the processing unit being adapted or configured to perform a particular step or task may correspond to that step or task being performed by any one or more of a plurality of processing components, either alone or in combination. The skilled person will understand how such a distributed processing arrangement can be implemented.
• the processing unit may include a communication module or input/output for receiving data and outputting data to further components.
• the one or more processors of the processing unit can be implemented in numerous ways, with software and/or hardware, to perform the various functions required.
• a processor typically employs one or more microprocessors that may be programmed using software (e.g., microcode) to perform the required functions.
• the processor may be implemented as a combination of dedicated hardware to perform some functions and one or more programmed microprocessors and associated circuitry to perform other functions.
• circuitry examples include, but are not limited to, conventional microprocessors, application specific integrated circuits (ASICs), and field-programmable gate arrays (FPGAs).
• ASICs application specific integrated circuits
• FPGAs field-programmable gate arrays
• the processor may be associated with one or more storage media such as volatile and non-volatile computer memory such as RAM, PROM, EPROM, and EEPROM.
• the storage media may be encoded with one or more programs that, when executed on one or more processors and/or controllers, perform the required functions.
• Various storage media may be fixed within a processor or controller or may be transportable, such that the one or more programs stored thereon can be loaded into a processor.
• a single processor or other unit may fulfill the functions of several items recited in the claims.
• a computer program may be stored/distributed on a suitable medium, such as an optical storage medium or a solid-state medium supplied together with or as part of other hardware, but may also be distributed in other forms, such as via the Internet or other wired or wireless telecommunication systems.
• a suitable medium such as an optical storage medium or a solid-state medium supplied together with or as part of other hardware, but may also be distributed in other forms, such as via the Internet or other wired or wireless telecommunication systems.

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• 2022
  • 2022-09-05 EP EP22193836.8A patent/EP4332980A1/de not_active Withdrawn
• 2023
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